West of England Genomic Medicine Centre Update for Breast Site Specific Group Catherine Carpenter-Clawson, Programme Manager

Contents Quick Reminder: What? Why? Who? Where? And finally: How will we do it? How are we doing?

What? Slide courtesy of NHS England

What are the aims - 100,000 Genomes project and genomic medicine Initiative to perform Whole Genome Sequencing on 100,000 samples from English NHS patients Make ‘genomic medicine’ part of standard care Diagnosis Prognosis Personalised treatment

What do we need to do - genome samples

Why?

Who are Genomics England? Genomics England is a wholly owned company of the Department of Health. Genomics England was set up to deliver the 100,000 Genomes Project by: Creating Genomic Medicine Centres Commissioning/working with a company Illumina to sequence 100,000 genomes Setting up Genomics England Clinical Interpretation Partnerships (GECIPs) to lead the clinical analysis

Who is a Genomic Medicine Centre? A group of NHS providers (and other key local organisations) who have come together to support delivery of the 100,000 Genomes Project We are ordinary NHS staff seconded to work on the project and set it up alongside existing clinical practice We are not building a big new centre or working outside of existing NHS structures

Where are the Genomic Medicine Centres NHS Genomic Medicine Centres (NHS GMCs) : mapped against AHSN boundaries NHS GMCs work in partnership with academia, patients and industry through the AHSNs 

How? 100,000 Genomes Project announced 4 years ago – since then established pathways and infrastructure to support genome sequencing Genomic England is set up to establish sequencing centre and pathways All 13 centres actively consenting patients to the project First 11 Genomic Medicine Centres announced Final 2 Genomic Medicine Centres established 100,000 Genomes Project is launched Dec 2012 Dec 2013 Dec 2014 Dec 2015 Dec 2016

How? First RD samples 10th Jun Designation as GMC 23rd Dec Go-live Cancer and RD 27th May First cancer consent 27th Jun Launch event 26th Sep Jan 16 Jan 17 Q1 review 22nd Jul Q2 review 24nd Nov

Specimen transport team Proposed pathway Pathology GPs Imaging Consultants Nursing staff Specialists Breast Care Research team Theatre team Clinic management MDT co-ordinators Specimen transport team IT experts How do you develop a pathway? – the key is engagement at every step of the pathway….. Tumour laboratory Blood laboratory Managers Reception Processing

Cancer roll out programme How we doing? Cancer roll out programme First Glos breast cancer patient consented Dry run for breast cancer in RUH North Bristol brain and colorectal patients consented Planned expansion to Colorectal in Glos underway Exploration of Haem Onc pathway options progressing

Cancer sample breakdown by pathway WE GMC Quarterly Review - 24/11/2016

Cancer trajectory to 26th Jan 2017

Deep dive of breast cancer pilot North Bristol Breast MDT pilot 6 weeks from 29th September

Genomics champions – to support education Name Main role Organisation James Bristol Consultant cancer surgeon Glos hospitals Giles Atton Foundation Doctor Year 2 NBT Sadaf Haque GP Macmillan and Cancer Lead Glos CCG Ellen Brennan-Rist Pharmacist Bath Anna Le Fevre Clinical genetics visiting fellow Bath & UHB Diane Barlow Childrens’ cardiac nurse specialist UHB Suriya Kirkpatrick Senior cancer clinical trials research nurse

Patient Public involvement – to promote patient collaboration National PPI consultation- consent materials, feedback on poster Contributed resources to national PPI group- PPI Toolkit, public contributor selection materials

Communications Information stand roadshows at Trusts Launch Event Press release to media Actively updated WEGMC website WEGMC news in stakeholder newsletters Clinical engagement and training

Informatics – to manage the complex data 1. Data extraction from Starlims system Operational errors now resolved, DNA sample transfer resumed Longer term strategy to improve longterm robustness 2. Longterm ‘Connecting Care’ solution for data submission Delayed introduced by external provider Intensive catch-up with launch date confirmed 8th December 3. Active programme of electronic input of HPO terms for RD and cancer register data Informatics lead appointed Aug16 Regional Informatics group established and active

Workforce Development – to support current & future staff ‘Box-Ed’ targeted engagement progressed to pilot stage @Bristol plans to develop community engagement package Targeted training packages in development Informatics Consenting Training needs analysis disseminated

Laboratory – to develop sample processing Samples exported to biorepository Logistic pathways for Glos LDP transport tested Fresh Frozen Pathway for Breast, Brain & Colorectal cancer live at North Bristol Trust Saturday working underway to facilitate clinics